Los Angeles County officials are prepared to close two clinics serving 4,000 mentally ill patients on the Westside and to slash funding for several private mental health agencies that serve hundreds more if a tax initiative on the November ballot is defeated.
Psychologists and social workers said last week that the proposed reductions threaten to further cripple an already thin supply of psychotherapeutic services for poor people on the Westside, sending some psychotic and schizophrenic patients into the streets and landing others in already overcrowded jails and hospitals.
County officials blame the proposed cuts, which countywide would total $40 million, on reductions in state funding. Only a significant increase in the state alcohol tax, proposed in Proposition 134 on the statewide Nov. 6 ballot, can stave off the drastic reductions, said Roberto Quiroz, director of the Los Angeles County Mental Health Department.
The so-called "nickel-a-drink" measure would raise about $760 million a year for a variety of social and health programs.
The initiative has been opposed by a well-financed ad campaign. Opponents say it should be defeated because it would lock into the state budget higher levels of spending than the increased alcohol tax would raise. Thus, they warn, it could lead to other tax increases.
If Proposition 134 is defeated, the cuts in the county's mental health budget could be adopted as soon as Nov. 15.
A contingency plan circulated last week among county employees and private mental health providers estimates the cuts would mean about 22,000 of the 52,000 mostly low-income patients who now receive mental health treatment in the county would go without care.
"Those people are seriously in need of some agency to help them meet the crises in their lives," said Ann Brand, director of the Didi Hirsch Community Mental Health Center in Culver City. "And those people are going to end up on your doorstep and on my doorstep and in much worse shape than they are now."
The plan to cope with the county's projected cash shortage contemplates closing 12 of the county's 23 public mental health clinics and drastically reducing grants to private, nonprofit agencies that serve the mentally ill poor.
Under the proposal, the Westside would lose the Hollywood Mental Health Services clinic and the West Central Family Mental Health Service clinic in the Crenshaw District. The Hollywood clinic serves 1,776 patients; the Crenshaw clinic more than 2,200.
Milagres Dias, director of the Hollywood clinic, predicted that many of the people served there will not be able to find service if the clinic closes.
"Their condition will deteriorate to the point of being unmanageable," said Dias, a psychologist. "As the stress level goes up, suicide attempts will also increase. They will simply have no place to go."
Traumatized patients would have trouble finding a downtown Skid Row clinic that would remain open to treat the most severely disturbed, Dias said. And he said that few other clinics offer Spanish-speaking therapists, as his does.
"Some people will just be stuck at home," he said. "Others will be in jails or come to the attention of police through violent outbursts."
Private agencies that depend on county grants would also be hit with a total of $16 million in cuts if the county plan goes ahead.
On the Westside, a West Los Angeles-based program called Westside Neighbors would be eliminated. It helps about 50 mentally ill people cope with apartment living in hopes they will not return to living on the streets.
The Beverlywood Resource Center on Robertson Boulevard also would close. The center provides group activities and vocational training for about 150 young adults with chronic mental illnesses.
The Culver City-based Didi Hirsch center would have to close several of its programs, including its Venice Division, which provides medication, therapy and group sessions for about 200 homeless, mentally ill people, said Brand, the center's director.
The health center would also be forced to shut the Jump Street shelter in West Los Angeles, which provides housing and treatment for homeless people with acute mental illnesses, Brand said. The shelter has six beds.
Excelsior House, a crisis treatment home for the mentally ill, would also shut its doors. The 14-bed home is located in Inglewood, but it primarily serves patients from the Westside, Brand said.
Quiroz said that if Proposition 134 loses, the proposed cuts cannot be avoided because the state has neglected its traditional responsibility for funding mental health programs, and there is no extra money in the county budget for the services.
In place of the closed clinics, the county would operate an emergency system: Ten regional offices would provide medication and track 3,000 of the most disturbed patients, and Psychiatric Mobile Response Teams would respond to calls for emergency psychiatric care.
The closures would continue a pattern of reductions for mental health services in the county.
Last year, the County Board of Supervisors closed five clinics--the Hubert H. Humphrey Mental Health Center in South-Central Los Angeles, the West San Fernando Valley Mental Health Center in Canoga Park, the East San Fernando Valley clinic in North Hollywood, the Coastal Community Mental Health Center in Carson and the Wilmington Mental Center. The county also reduced staffing and service at seven other locations, including the Hollywood and Crenshaw clinics.